Prevalence of asthma and associated factors among male late adolescents in Tabriz, Iran

Dairy intake in association with asthma symptoms among a large sample of children and adolescents: a cross-sectional study

Background and objective

Dairy products may be associated with an increased risk of asthma, although there is little scientific evidence to support this association. The goal of this study was to explore the association between dairy consumption and asthma symptoms.

Materials and methods

This cross-sectional study was conducted on children and adolescents aged 6-8 and 13-14 years living in central Iran. Dietary food consumption was assessed using a multiple-choice questionnaire. Logistic regression was used to obtain odds ratios for the association between milk, other dairy products, and total dairy consumption with the risk of asthma symptoms.

Results

In total, 7,667 participants (3,414 boys and 4,253 girls) were included in the current study. Milk intake and total dairy consumption were not associated with the likelihood of wheezing, asthma confirmed by a doctor, current asthma, and asthma medication use. In addition, there was no association between other dairy product intake and the odds of wheezing in the past 12 months in the crude model. However, after adjusting for several confounders, those in the top category had lower odds of wheezing in the past 12 months than those in the bottom category (OR: 0.58; 95% CI: 0.40-0.85).

Conclusion

The consumption of dairy products other than milk, including cheese and yogurt, might reduce the likelihood of wheezing in children and adolescents.

Prevalence of overweight and obesity among Iranian population: a systematic review and meta-analysis

BACKGROUND

Obesity is a major risk factor for chronic diseases. Politicians and practitioners should be aware of the dramatic increase in obesity and its subsequent complications to prevent associated health risks. This systematic review aimed to provide better insight into the prevalence of overweight and obesity in the Iranian population.

METHOD

An evaluation was conducted on all published observational studies from both national (SID, Irandoc, Iranmedex) and international (Web of Knowledge, PubMed, Scopus) sources, which reported the prevalence of overweight/obesity among normal population samples, between January 2012 and December 2021.

RESULT

A total of 152 eligible studies were included in this meta-analysis. Of the 152 selected studies, 74 reported the prevalence of overweight/obesity in patients aged ≤ 18 years, and 61 studies in adults. In the rest of the articles (17 studies), the results were reported for a combination of these age groups. The prevalence of overweight and obesity in Iran was estimated at 20.1 (95% CI 17.92-22.30) and 13.44 (95% CI 11.76-15.22), respectively. This percentage (95% CI) was 11.71 (10.98-12.46) for overweight and 8.08 (7.02-9.22) for obesity in those aged ≤ 18 years, and 35.26 (32.61-37.99) for overweight and 21.38 (19.61-23.20) for obesity in those aged > 18 years. The overall prevalence of overweight and obesity in the entire population was 35.09% (95% CI 31.31-38.98).

CONCLUSION

As obesity is on the rise in Iran, we should seek both weight loss strategies and ways to control comorbidities associated with high BMI.

Status of TNF-α and IL-6 as pro-inflammatory cytokines in exhaled breath condensate of late adolescents with asthma and healthy in the dust storm and non-dust storm conditions

Exposure to airborne particulate matter (PM) can be considered as an important risk factor for human health. Some cytokines have been recognized as the biomarkers of exposure to air pollution. Experimental studies indicate that PM exposure could be associated with inflammation. Thus, the purpose of this study was to evaluate whether the exposure to air PM is associated with biomarkers of inflammation. The specific aim of this study was to determine the correlation between airborne PM levels and IL-6 and TNF-α as airway inflammation biomarkers among two groups of late adolescents in northwest of Iran. This study included 46 subjects, comprising 23 asthmatic subjects and 23 non-asthmatic persons. Environmental PM (PM₁₀, PM_2.5 and PM₁) levels were measured in dust storm and non-dust storm days during both cold and warm seasons. Following the sampling of PM, Two pro-inflammatory cytokines of IL-6 and TNF-α in exhaled breath condensate (EBC) were also determined in the EBC samples via commercial ELISA kits. Daily mean ambient air PM₁₀, PM_2.5 and PM₁ concentrations during the dust storm days was 221.79, 93.13 and 25.52 μg m^-3 and in non-dusty days 48.37, 18.54 and 6.1 μg m^-3, respectively. Biomarkers levels were significantly (p < 0.001) higher in asthmatic students compared to the non-asthmatic subjects. EBC cytokines levels were increased in dust storm days compared to the non-dusty days (p < 0.001) and were positively correlated with different size of ambient PM concentration. Dust storm conditions can increase the pro-inflammatory cytokines and cause adverse effects on pulmonary health and lung tissue damage.

Spatiotemporal variability of exposure to secondhand smoke in Iran during 2009-2020: a systematic review

The present study aimed to provide a systematic review of studies on the prevalence of secondhand smoke (SHS) exposure in the Iran population as a serious indoor health hazard. A literature review of studies that considered SHS exposure, available in multiple electronic databases including Web of Science, PubMed, and Scopus published 2009-2020 in English and two Persian databases (SID and Magiran), was carried out following the PRISMA recommendations. A total of 55 studies were included based on the inclusion and exclusion criteria and the quality assessment. The results showed no specific decrease in the prevalence of exposure to secondhand smoke in Iran; however, it appeared that the exposure has been increasing. Distribution of studies in terms of age group revealed that most studies (38%) investigated adults (more than 18 years old), while 34% of the studies considered less than 18 years of age group and a single article considered infants (6-24 months). Based on the present study results, a large population of Iran was exposed to SHS. Moreover, based on Iran's STEPs 2016 (Stepwise Non-communicable Diseases Risk Factors Survey in Iran) study, the overall prevalence of SHS exposure at home (57.5%) was higher than in workplaces (49.2%). The results of the present study recommended that protection measures should be comprehensive in terms of exposure places, and since the exposure prevalence in some provinces was higher than the others, it is especially important to consider the local measures and cultural aspects in SHS control programs.

The Prevalence of Asthma among Iranian Children and Adolescent: A Systematic Review and Meta-Analysis

BACKGROUND

Asthma is an important reason for hospitalization in children aged under five years. Information about the current status of asthma in Iranian children can help the Iranian health sector plan carefully and prevent asthma incidence by educating the families. The present systematic review and meta-analysis is aimed at estimating asthma prevalence in Iranian children and adolescents.

METHOD

Data were found using keywords such as prevalence, epidemiology, asthma, adolescent, children, pediatrics, Iran in Web of Science, Scopus, PubMed, Cochrane, and Embase databases. Three national databases, including Magiran, Barakat Pharmed Co (Iran medex), and Scientific Information Databank (SID) were searched until 1 October 2020. Cross-sectional and original studies were included in the study, and then, quality assessment was done using the National Institutes of Health's Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. A pooled estimated prevalence of asthma was calculated using Der Simonian-Laird random model. Egger's test was used to evaluate publication bias. The data were analyzed using the STATA software version 16.

RESULTS

30 studies were selected and investigated. The prevalence of asthma in children and adolescents was 6% and 8%, and the prevalence in boys and girls was 9% and 8%, respectively. Among the asthma symptoms, wheezing had the most prevalence (17% in children and 19% in adolescents) and sleep disturbance had the lowest prevalence (6% in children and 6% in adolescents).

CONCLUSION

The prevalence of asthma in Iranian children and adolescents is lower than in the world. Existing strategies should be pursued followed. Also, guidelines for asthma control and prevention should be considered in the future.

Proinflammatory effects of dust storm and thermal inversion particulate matter (PM10) on human peripheral blood mononuclear cells (PBMCs) in vitro: a comparative approach and analysis

Particulate matter (PM) as the carcinogenic air pollutants can lead to aggravated health outcomes. Epidemiological studies demonstrated that PM can be engaged in different diseases such as cardiovascular, respiratory and cancer. The in vitro secretion of proinflammatory cytokines by human peripheral blood mononuclear cells (PBMCs) has been used to assess the effects of PM with an aerodynamic diameter < 10 μm (PM10). This study compared the proinflammatory cytokines tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6), and interleukin 1-beta (IL1-β) secretions of PBMCs exposed to PM10 of dust storm and inversion. We collected PM10 samples during the spring and autumn seasons in two locations. Isolated PBMCs were exposed separately to 50, 150, and 300 μg/ml of different type of PM10 for 4 and 24 h. The mean concentrations of TNF-α for the PM of dust storm and inversion were 6305.61 ± 2421 and 6651.74 ± 2820, respectively. Also the mean concentrations of IL1-β for the PM of dust storm and inversion were 556.86 ± 162 and 656.35 ± 196, respectively. Furthermore, these values for the production of IL-6 were 12,655 ± 5661 and 16,685 ± 8069, respectively. Although no significant difference was observed between the PM of dust storm and that of inversion with regard to PBMCs, the results showed a significant increase in the proinflammatory cytokine secretion of both PMs compared with the controls. Moreover, TNF-α, IL1-β, and IL-6 secreted in cells exposed to PM10 of dust storm were about 10 times more than the controls, these values for cells exposed to PM10 of inversion were around 10, 12, and 14 times more than the controls, respectively. It can be concluded that the PM10 of both dust storm and inversion can play a significant role in proinflammatory cytokine secretion due to its harmful effect on human health. Graphical abstractThis picture shows the Proinflammatory cytokine producing potential of PM10 with two sources (dust storm and urban air pollution) in exposure with human PBMCs in vitro.

Chemical composition of PM10 and its effect on in vitro hemolysis of human red blood cells (RBCs): a comparison study during dust storm and inversion

PURPOSE

This study aimed to investigate chemical composition of PM₁₀ (particulate matter with aerodynamic diameter ≤ 10 μm) during dust storm and inversion in Tehran and hemolysis effects.

METHODS

PM₁₀ was sampled in Tehran, Iran, during dust storm and inversion conditions. Water soluble ions (F¯, Cl¯, NO₂¯, NO₃¯, SO₄¯², Na⁺, K⁺, NH₄ ⁺, Ca⁺², Mg⁺²) and elements (Al, Ba, Cd, Co, Cr, Cu, Fe, Li, Mn, Mo, Ni, Pb, Se, Sn, Sr, V, Zn, Pt, Rh, Pd, As and Si) were analyzed by ion chromatograph (IC) and inductively coupled plasma optical emission spectrometer (ICP-OES), respectively. Hemolysis was examined as in vitro at PM₁₀ concentrations of 50-300 μg/ml.

RESULTS

Daily average of PM₁₀ concentrations in dusty and inversion days were 348.40 and 220.54 μg/m³, respectively. Most prevalence ionic components were NO₃¯, Cl¯, SO₄¯² and Ca⁺² during dust storm and SO₄¯², NO₃¯, Cl¯ and NH₄ ⁺ during inversion. Si, Fe and Al had the maximum values in both conditions. Particles associated with both conditions induced hemolytic responses. PM₁₀ from dusty day showed a higher hemolysis percent (10.24 ± 4.67%) than inversion (9.08 ± 5.47%), but this difference was not significant (p = 0.32). Hemolytic effects were significantly intensified by increased PM concentrations (p < 0.001) in a dose-response manner.

CONCLUSIONS

As the results, chemical composition of sampled particles from inversion days and dust storm was different from each other. Hemolytic effects of particles during dust storm were more than inversion days. However, this difference was not statistically significant.

A ubiquitous asthma monitoring framework based on ambient air pollutants and individuals' contexts

Air pollutants and allergens are the main stimuli that have considerable effects on asthmatic patients' health. Seamless monitoring of patients' conditions and the surrounding environment, limiting their exposure to allergens and irritants, and reducing the exacerbation of symptoms can aid patients to deal with asthma better. In this context, ubiquitous healthcare monitoring systems can provide any service to any user everywhere and every time through any device and network. In this regard, this research established a GIS-based outdoor asthma monitoring framework in light of ubiquitous systems. The proposed multifaceted model was designed in three layers: (1) pre-processing, for cleaning and interpolating data, (2) reasoning, for deducing knowledge and extract contextual information from data, and (3) prediction, for estimating the asthmatic conditions of patients ubiquitously. The effectiveness of the proposed model is assessed by applying it on a real dataset that comprised of internal context information including patients' personal information (age, gender, height, medical history), patients' locations, and their peak expiratory flow (PEF) values, as well as external context information including air pollutant data (O₃, SO₂, NO₂, CO, PM₁₀), meteorological data (temperature, pressure, humidity), and geographic information related to the city of Tehran, Iran. With more than 92% and 93% accuracies in reasoning and estimation mechanism, respectively, the proposed method showed remarkably effective in asthma monitoring and management.

Short-term effects of particle size fractions on lung function of late adolescents

Although ambient air pollution has been linked to reduced lung function in healthy students, longitudinal studies that compare the response of asthmatic and healthy adolescents are lacking. To evaluate lung function responses to short-term ambient air particulate matter (PM₁₀, PM_2.5, and PM₁) levels, we conducted a study on high school students aged 15-18 years. The aim of this study was to assess effects of acute exposure to ambient air particulate matter (PM) on lung function in healthy and asthmatic late adolescents. We examined associations of lung function indices and ambient PM levels in 23 asthmatic and 23 healthy students. Paired-samples T test was used to evaluate the association of exposure to airborne PM concentrations with lung function test results (FVC, FEV₁, FEV₁/FVC, and FEF_25-75). We observed negative impact of exposure to an increased concentration of ambient air PM₁₀, PM_2.5, and PM₁ on lung function parameters of asthmatic and healthy late adolescents. These findings are consistent with other similar short-term studies which have confirmed the adverse effect of PM air pollution. These associations were stronger in asthmatic subjects compared with those in healthy ones. There are significant adverse effects of ambient air PM on pulmonary function of adolescents, especially asthmatics.